Objective To study the efficacy of butylphthalide soft capsules in the treatment of mild and moderate top of the basilar syndrome.Methods Sixty patients with mild and moderate top of the basilar syndrome were randomly divided into treatment and control groups (30 cases each). The patients in the control group were given conventional treatment and those in the treatment group were administered with butylphthalide soft capsules based on the conventional treatment. The course of the treatment was 14 days. Nerve function and activities daily living were evaluated by NIHSS and BI scores before treatment and the 7th and 14th days after treatment.Results NIHSS scores were reduced and BI scores were increased significantly in the two groups after treatment (P<0.05). The NIHSS scores in the treatment group on the 7th and 14th days after treatment were significantly lower than those before treatment and the control group (P<0.05). The BI scores in the treatment group were significantly higher than those before treatment and the control group on the 7th and 14th days after treatment (P<0.05).Conclusions Butylphthalide soft capsules is effective in the treatment of mild and moderate top of the basilar syndrome.